How to Manage Prediabetes and Prevent Diabetes

Prediabetes occurs when blood sugar levels are higher than normal but not quite at the level of diabetes. High blood sugar levels occur in prediabetes when the body does not properly respond to insulin (a hormone that allows cells to use sugar for energy).

People with prediabetes are at higher risk of developing type 2 diabetes, a chronic metabolic disease that can cause problems such as heart, eye, kidney, and nerve damage. Taking steps to manage prediabetes can help reduce the risk of developing type 2 diabetes by up to 70%.

In this article, you will learn the goals for managing prediabetes, ways to manage prediabetes through lifestyle changes, prescription medication options, and how to manage prediabetes in children.

Person enjoying jogging to manage prediabetes

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Goals for Managing Prediabetes

Having prediabetes raises the risk of developing type 2 diabetes and other health problems such as high blood pressure, heart disease, and abnormal blood cholesterol. The goals for managing prediabetes are to lower the risks of developing these conditions as well as to improve quality of life.

Management of prediabetes goals includes improving or maintaining optimal blood sugar levels, reaching weight management goals, and improving cardiovascular markers such as blood pressure and cholesterol.

What to Know About Prediabetes Testing

There are three types of tests used to diagnose prediabetes. An A1C test measures average blood sugar levels over the past three months, a fasting glucose test measures current blood sugar levels, and a two-hour post-75-gram oral glucose challenge looks at your body’s response to ingesting sugar.

The A1C and fasting glucose tests are often included in routine blood tests for yearly physicals. People with results that fit one or more of the following parameters will be diagnosed with prediabetes:

  • A1C levels between 5.7% and 6.4%
  • A fasting glucose level between 100 and 125 milligrams per deciliter (mg/dL)
  • A glucose challenge level between 140 and 199 mg/dL

Lifestyle Changes

There are many steps you can take to manage prediabetes and lower your risk of developing type 2 diabetes and other health problems associated with diabetes.


Making healthy changes to what you eat can help manage prediabetes. Though every person is unique and has different nutritional needs, there are general ways to change your diet to manage prediabetes effectively.

These include:

  • Focusing on whole plant-based foods such as vegetables, beans, nuts, seeds, fruits, and whole grains
  • Increasing dietary fiber intake by eating more whole foods like vegetables and whole grains
  • Limiting added sugars and refined grains
  • Limiting or avoiding highly processed foods

Some people may find it difficult to change the way they eat. Making small changes can add up over time. These include:

  • Eating fruit instead of pie or cookies
  • Cutting back on soft drinks and juice and replacing them with water or other zero-calorie drinks
  • Eating at least one vegetable each day for dinner
  • Roasting, boiling, or steaming foods instead of frying them
  • Making one meal a week a meat-free meal

Managing Weight

Maintaining a healthy weight can delay or prevent the progression to type 2 diabetes. For people who are overweight or obese, losing weight can reduce the risk of developing type 2 diabetes and other cardiovascular complications like high blood pressure.

One study found that for every 2.2 pounds lost, the risk of developing diabetes decreased by 16%. Changing your diet and increasing physical activity levels can help you reach and maintain a healthy weight.

Physical Activity

Physical activity is an effective and low-cost way to prevent type 2 diabetes.

Increasing physical activity has been shown to lower blood sugar levels and improve body composition. People who increase their daily activity have been shown to reduce their A1C levels.

You don’t need to start an extreme exercise regimen to increase physical activity. Walking is great exercise, and incorporating small bits of movement into your daily activities can go a long way.

Taking the stairs instead of the elevator or parking farther from the entrance to the store can increase your daily activity. Household chores like vacuuming or mowing the lawn can also contribute to your physical activity.

Quitting Smoking

Smoking increases the risk of developing type 2 diabetes. Smoking can also increase the risk of cardiovascular disease, which is already elevated in people with prediabetes. Quitting smoking can reduce these risks. If you smoke and have prediabetes, talk to your healthcare provider about healthy ways to quit.

Some people who stop smoking tend to gain weight. An increase in weight can affect insulin resistance (the body’s ability to use insulin to process sugar), which can impact blood sugar levels and prediabetes. Talk to your healthcare provider about ways to quit while managing weight.

Good Sleep Habits

Poor sleep can raise blood sugar levels and increase insulin resistance. Not getting enough sleep due to stress, overwork, or a sleep disorder such as sleep apnea can all raise the risk of developing type 2 diabetes.

It is important to get seven to nine hours of sleep each night. Regular exercise can help with better sleep. Other ways to improve sleep include:

  • Avoiding caffeine late at night
  • Creating a night-time routine that helps you relax, such as taking a bath or reading a book
  • Eliminating distractions such as cellphones from the bedroom

Prescription Medication

Though lifestyle interventions can go a long way toward preventing or delaying the progression from prediabetes to type 2 diabetes, prescription medications may also help.

The most common medication prescribed for people with prediabetes is Fortamet or Glucophage (metformin). Metformin has been shown to lower fasting blood sugar levels and A1C.

Thiazolidinediones like Actos (pioglitazone) are another class of drug for treating prediabetes. These medications work by making the body’s cells more sensitive to insulin and preserving the body’s ability to process insulin.

Glucosidase inhibitors such as Precose (acarbose) work by slowing carbohydrate digestion and decreasing the rate at which the body absorbs sugar. Sometimes these medications are taken in conjunction with other anti-diabetic drugs to slow or stop the progression to type 2 diabetes.

Incretins like Byetta (exenatide) work by decreasing appetite and keeping the stomach full, thus leading to weight loss, which can help manage prediabetes.

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are emerging as important for diabetes (reducing A1C) and obesity, and they likely have cardioprotective effects. These include:

  • Invokana (canagliflozin)
  • Farxiga (dapagliflozin)
  • Jardiance (empagliflozin)
  • Steglatro (ertugliflozin)

Anti-obesity drugs like Alli (orlistat) can address obesity specifically. These medications reduce fat absorption by nearly 30%, leading to weight loss. This can reduce the risk of developing type 2 diabetes.

Managing Prediabetes in Children

For children with prediabetes, intensive lifestyle modification programs are key to managing the disease and preventing type 2 diabetes. Changing eating habits and increasing physical activity are the two most important components of managing prediabetes in children.

Children with prediabetes should increase their intake of vegetables and fruits, eat more fiber, stop drinking sugar-sweetened beverages, and decrease the amount of saturated fat they consume.

Adding more physical activity to a child’s daily routine helps with weight loss and decreases blood sugar levels. Children should get at least 30 minutes of moderate to vigorous physical activity a day and should aim to increase this to 60 minutes a day.

Some high-risk children may also need prescription medications like metformin to help regulate blood sugar levels and prevent type 2 diabetes.


Managing prediabetes can help prevent type 2 diabetes and other complications like high cholesterol and high blood pressure. Lifestyle interventions such as eating a healthy diet, increasing physical activity, quitting smoking, and getting enough sleep can all help slow or stop the progression to diabetes.

Medications for prediabetes include anti-diabetic drugs like metformin and anti-obesity drugs like orlistat. Children with prediabetes can manage the condition with intensive lifestyle changes to their diet and activity levels and, in some cases, medication.

Frequently Asked Questions

  • What foods do you need to avoid if you have prediabetes?

    If you have prediabetes, you should limit your intake of highly processed foods, fried foods, and foods high in sugar, like sodas, cookies, and cakes. 

  • Do you need to take medication to manage prediabetes?

    Not everyone with prediabetes will need to take medication. Some people can manage the disease with lifestyle interventions alone.

  • How do you treat prediabetes naturally?

    Prediabetes can be managed naturally with lifestyle changes such as eating a healthy diet full of whole, unprocessed foods, increasing physical activity, quitting smoking, and getting enough sleep.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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